Management of locally advance carcinoma breast [stage III]

The aim of this study was to see the prognosis of patients with locally advanced carcinoma breast after primary surgical intervention followed by adjuvant therapy and to evaluate possible complications. The study includes 50 patients; Most of them were postmenopausal with stage IIIA carcinoma breast with age ranging from 51-60 years. Modified radical mastectomy was the primary procedure followed by radiotherapy and chemotherapy. Tamoxifen given to postmenopausal women. Patients were followed up for one year. Locoregional recurrence and distal metastases occurred mostly in stage IIIB patients and also that the prognosis of patients with LABC is poor due to late presentation, bigger size of tumour and axillary metastasis

Carcinoma breast, late presentation: a big concern

To study the different presentation patterns and their treatment options in advanced carcinoma breast. A retrospective observational study North Surgical Ward, Mayo Hospital, Lahore, from November 2004 to April 2006. In total, 156 patients with carcinoma breast, confirmed histopathologically by biopsy and /or FNAC, were included in this study. Information was gathered from them using a structured questionnaire. The peak incidence of carcinoma breast was found to be between 31- 45 years of age. Majority of these patients presented in stage II [22%]. Maximum number of patients presented in stage III [56%]. However stage IV disease was also found in 12% of patients population. But stage I disease was least commonly presented disease [10%]. And infiltrative ductal carcinoma was the most prevalent [94%] histologic type. Modified radical mastectomy was the surgical treatment adopted in about 72% of cases with adjuvant or neoadjuvant chemotherapy. Advance stage breast lump with local or locoregional spread remained the commonest mode of presentation of carcinoma breast. And infiltrative ductal carcinoma is the commonest histologic variant. Majority of the of patients with carcinoma breast in Pakistan still present in advanced stages where almost no cosmetically more acceptable surgical procedure can be carried out

Occupational hazards for surgeons

In spite of the radical advances made in the field of surgery to save lives, we find it is the surgeons who are becoming the patients by being exposed to a host of occupational hazards, which places them at a significant risk of acquiring many infectious diseases in addition to other safety threats. In context to guidelines set down by International Labor Organization the hazards a surgeon can face at work can be broadly categorized into Accidental, Chemical, Biological, and Ergonomic, Psychosocial and Organizational Hazards. To identify the occupational hazards surgeons face in our set-up and their inevitable consequences as compared to international standards. Setting The survey was carried out in a major tertiary care hospital of Lahore with inspection of operation theatres, surgical emergency room, and surgical wards. The surgeons in our setup are exposed to infectious diseases such as Hepatitis B and C, HIV and typhoid via accidental pinpricks from infected needles and s harps due to multiple hazards. Other risks include latex sensitization, back problems, post-traumatic stress syndrome and many others. Spread of awareness of these occupational hazards should be undertaken with a change in attitudes